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"Treatment is worse than the disease". This is also true in cancer treatment, where many drugs have measured effects on reducing tumor size and yet not increasi

"Treatment is worse than the disease". This is also true in cancer treatment, where many drugs have measured effects on reducing tumor size and yet not increasing survival times...yet the side effects make the patients' quality of life significantly worse.

polyfractal 7y ago
I don't think this is fair for several reasons. First, cancer treatment drugs are tested heavily in-vitro first, where the only significant metric is reduction of tumor mass. Clinical trials for cancer treatments are different from other drugs, as you don't generally do double-blind trials (would you want to get a placebo if you had a terminal cancer? No, probably not). So many cancer treatments go into clinical trials with only the evidence that it shrinks tumors, and tends to kill tumors faster than it kills the rest of your body. Side effects are expected to be severe since most cancer treatments are quite literally killing any cells that divide... tumors just divide faster and thus get hit harder. The end result is cancer treatment often has very poor quality of life. Clinical researchers _do_ perform analysis to see if survival increases relative to other treatments. But often you don't know until you've already tried it on a cohort of patients (with their consent, obviously). There is push-back in the medical field in areas for what you suggest. For example, colonoscopies are becoming widely recognized as causing more problems than they solve. The complications they can induce tend to lead to a poorer patient outcome than missing colon cancer because you didn't screen (e.g. survivability is not affected by finding/treating colon cancer early). I just don't think it's fair to paint cancer treatments with the same brush strokes, since dealing with terminal diseases is a totally different ball game. Edit: I should say, there are some parts of cancer treatment which is moving towards the dont-treat opton. For example, there is growing evidence that treating prostate cancer is not necessary, since you'll probably die of something else long before prostate cancer kills you (it is very slow growing on average)
- cannonedhamster 7y ago
  The other problem with cancer is that there are different types of cancer cells. There's the fast dividing and there's also the cancer stem cells which can lay dormant for years without dividing. This is the reason for most cancer returning. There's a promising new tech that hopefully pans out that activates these cells so standard chemo can attack them. Regarding clinical trials, they are very selective. You have to for a very specific criteria and your cancer needs to be measurable by a CT scanner typically to prove efficacy. Add to that the typical cancer patient is either a child or an older person and you're bound to have poorer results.
cannonedhamster 7y ago
So... As a cancer patient myself going through chemo, I'll take the chemo over the cancer any day if the week. While some chemo treatments suck, it typically depends on what stage you're at, if you're curable, your comorbidities, and your personal genetics. I can say without any doubt whatsoever I'm alive right now because of chemo. Reducing the tumor allowed me to eat, which has kept me from wasting away into death. Survival times tend to increase with treatment, however quality of life of that survival time is reduced drastically for some people which I believe is what your point is not accurately reflecting, but again it's different for every single patient. I'm young, otherwise healthy, and I'm tolerating the chemo far better than expected with a far better response than average. I'm halfway through average expected survival time and if I live 2 more years I'll be drastically beating the odds. Right now that looks possible for me and that's because of the cancer treatment. There's also been a groundswell of new standard treatments, premeds, and novel treatments as better understanding of the disease in the past 10 years is just starting to bear fruit. If you look at survival rates of some common cancers in the United States many of them are downright not terrible odds of surviving through unless you catch them very late in their development.
- hurrdurr2 7y ago
  Thank you for your story. I hope you make through the treatment and beat this thing.

polyfractal 7y ago

I don't think this is fair for several reasons. First, cancer treatment drugs are tested heavily in-vitro first, where the only significant metric is reduction of tumor mass. Clinical trials for cancer treatments are different from other drugs, as you don't generally do double-blind trials (would you want to get a placebo if you had a terminal cancer? No, probably not). So many cancer treatments go into clinical trials with only the evidence that it shrinks tumors, and tends to kill tumors faster than it kills the rest of your body. Side effects are expected to be severe since most cancer treatments are quite literally killing any cells that divide... tumors just divide faster and thus get hit harder. The end result is cancer treatment often has very poor quality of life. Clinical researchers _do_ perform analysis to see if survival increases relative to other treatments. But often you don't know until you've already tried it on a cohort of patients (with their consent, obviously). There is push-back in the medical field in areas for what you suggest. For example, colonoscopies are becoming widely recognized as causing more problems than they solve. The complications they can induce tend to lead to a poorer patient outcome than missing colon cancer because you didn't screen (e.g. survivability is not affected by finding/treating colon cancer early). I just don't think it's fair to paint cancer treatments with the same brush strokes, since dealing with terminal diseases is a totally different ball game. Edit: I should say, there are some parts of cancer treatment which is moving towards the dont-treat opton. For example, there is growing evidence that treating prostate cancer is not necessary, since you'll probably die of something else long before prostate cancer kills you (it is very slow growing on average)

cannonedhamster 7y ago
The other problem with cancer is that there are different types of cancer cells. There's the fast dividing and there's also the cancer stem cells which can lay dormant for years without dividing. This is the reason for most cancer returning. There's a promising new tech that hopefully pans out that activates these cells so standard chemo can attack them. Regarding clinical trials, they are very selective. You have to for a very specific criteria and your cancer needs to be measurable by a CT scanner typically to prove efficacy. Add to that the typical cancer patient is either a child or an older person and you're bound to have poorer results.

cannonedhamster 7y ago

So... As a cancer patient myself going through chemo, I'll take the chemo over the cancer any day if the week. While some chemo treatments suck, it typically depends on what stage you're at, if you're curable, your comorbidities, and your personal genetics. I can say without any doubt whatsoever I'm alive right now because of chemo. Reducing the tumor allowed me to eat, which has kept me from wasting away into death. Survival times tend to increase with treatment, however quality of life of that survival time is reduced drastically for some people which I believe is what your point is not accurately reflecting, but again it's different for every single patient. I'm young, otherwise healthy, and I'm tolerating the chemo far better than expected with a far better response than average. I'm halfway through average expected survival time and if I live 2 more years I'll be drastically beating the odds. Right now that looks possible for me and that's because of the cancer treatment. There's also been a groundswell of new standard treatments, premeds, and novel treatments as better understanding of the disease in the past 10 years is just starting to bear fruit. If you look at survival rates of some common cancers in the United States many of them are downright not terrible odds of surviving through unless you catch them very late in their development.

hurrdurr2 7y ago
Thank you for your story. I hope you make through the treatment and beat this thing.